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How Combining Conversational AI and Visual Stories Can Increase Colorectal Cancer Screenings

Posted on by mPulse Team

In today’s world of information overload, capturing health plan members’ attention and encouraging them to take preventive health measures isn’t easy. It’s even more challenging when members are experiencing health disparities due to race, ethnicity, socioeconomic factors, and other social determinants of health. To address this challenge, mPulse Mobile created an innovative way to encourage members to get screened for colorectal cancer.

Specifically, mPulse’s approach combines text messages powered by conversational AI with visual storytelling to address misconceptions, raise awareness, model healthy behaviors, add an element of humor, and build overall health literacy.

To evaluate the clinical value of this approach, mPulse and The AltaMed Institute for Health Equity partnered to research the impact of text messages and fotonovelas on encouraging colorectal cancer screenings with socially vulnerable groups. They conducted a study to determine whether members were more likely to get screened after receiving

  • A series of bidirectional texts that tailor responses to address individual screening barriers, and
  • Fotonovelas or illustrated comic strips that tell a story explaining the importance of early detection and encouraging screenings.

An important motivation was to use culturally relevant messaging to engage these groups and to measure whether it could yield improvements in outcomes equitably across populations.

Evaluators at the Center for Community Health and Evaluation (CCHE), part of the Kaiser Permanente Washington Health Research Institute, independently evaluated the intervention. The results, recently published in JMIR Cancer, a peer-reviewed journal focusing on innovation and technology in cancer care and research, were very positive: nearly 40 percent of patients who received texts and fotonovelas responded, and they had significantly higher screening rates than those who did not receive the texts and fotonovelas.

The program was developed by mPulse and combined interactive text messages and fotonovelas to educate and activate patients throughout the four-week outreach. When patients shared their reasons for not completing the screening, the conversational AI platform provided relevant automated responses to address these barriers and to influence their health beliefs and behavior.

A Closer Look at Colorectal Cancer

Colorectal cancer is the second-leading cause of cancer death in the US, accounting for an estimated 151,030 new cases and 52,580 deaths in 2022. With appropriate screening, however, it is mostly preventable and can be treated successfully when localized and diagnosed early. Indeed, the five-year relative survival rate for localized colorectal cancer is more than 90%.  

Several screening tests can be used to find polyps or colorectal cancer, including an at-home stool test known as the fecal immunochemical test (FIT) which uses antibodies to detect blood in the stool. Upon completing the test, the patient mails it back to the health plan.

Barriers to Screening

A key step in improving screening rates is understanding why patients don’t get screened.

Studies have identified several potential barriers, including feeling fine and not understanding the need for the test, being busy or forgetful, expressing fear about what the test may indicate, the potential risk of perforation, embarrassment about a fecal collection procedure, concerns about mailing fecal matter, mistrust of the healthcare system, and the cost of follow‐up colonoscopy. Limited health literacy is another stumbling block, particularly when combined with cultural health beliefs and linguistic barriers.

The barriers impacting different populations vary which contributes to differences in screening rates and cancer diagnoses. For example, researchers report that Hispanics have significantly lower rates of screening for colorectal cancer than non-Hispanic Whites, and are more likely to be diagnosed with advanced disease.

The Study

AltaMed, the largest federally qualified community health center (FQHC) in California, and one of the largest nonprofit FQHCs in the nation, serves approximately 300,000 patients across Southern California and routinely mails out FIT kits to patients due for colorectal screening.

As part of usual care, about 11,000 patients who were due for a screening received a text message with a link to an instructional video, a follow-up text reminder, and a call from a patient navigator within a month if they still hadn’t returned the FIT kit.

Three months after the kits were mailed, 5,241 patients, age 50-75 years, had not returned the FIT kit and they were randomized into two groups for the study: the intervention group which received additional outreach (texts and fotonovela over four weeks), and the control group (no additional outreach).

A majority of patients in the intervention group were Hispanic or Latin American. mPulse has developed an index to map social determinants of health (SDOH) impact levels (using several census variables) and over 75% of patients in the study were living in neighborhoods where SDOH might negatively impact health access and health equity, resulting in health disparities.

The texts and fotonovelas were designed and implemented by mPulse to educate, remind, and encourage patients to return their FIT kit. All text messages were in patients’ preferred language, either English or Spanish, and written at a sixth-grade reading level or lower. 

In the first week, the texts focused on building health literacy about colon cancer and screenings, and the purpose of the FIT kit. Week two texts sought to uncover barriers by asking why the patient hadn’t yet taken the test. The next week gathered feedback on the fotonovela and its impact on health beliefs and behaviors; and the last week was a final reminder to mail back the kit.

If patients replied to the texts, the conversational AI used natural language understanding (NLU) to “listen” for known barriers and other expected replies and provided automated responses to create logical conversation flows.

Conversational AI

Patients could text back in their own words, and their responses were handled using rules and conversational AI. This was also an opportunity to build health literacy and raise awareness about the need to get screened regularly. Here is a sample conversation:

Patient’s reply:

“I don’t know why I need the test; I feel fine and have no symptoms.”

Automated response:

“It turns out most people with colon cancer feel healthy and have no symptoms. And most people with colon cancer also have no family history of the disease. This is a quick and easy way to find out if there are any problems.”

Similarly, if a patient replied, “I’m worried about getting COVID-19 if I come into the clinic”, the system was listening for COVID anxiety and would respond immediately by reassuring the patient using conversational AI.

The automated response was: “You don’t need to come into the clinic right now. Just mail back the FIT colon health test kit that we sent you in the mail. If the results are abnormal, somebody from AltaMed will contact you. Don’t let your worries about coronavirus get in the way of completing the test. It’s quick and easy!”

Thus, patients received timely and relevant information as part of a meaningful back-and-forth dialogue in real time.

Fotonovelas

The fotonovelas were created to address barriers such as procrastination, lack of self-care, lack of time, embarrassment about the process, and fear of results. They were developed in Spanish and English, in collaboration with the AltaMed Institute for Health Equity, and there were separate versions for men and women.

To ensure that the fotonovelas were compelling, the storyline used characters who were 50–75-year-old Hispanic or Latino patients and who looked and talked like they could be the patient’s best friend or neighbor. And the fotonovelas reflected the central role of family in the Latino community by emphasizing that the characters were getting screened not just for their own health, but for the sake of their loved ones as well. All fotonovelas also contained a call to action for patients to use and return the kit. Sample frames are shown below for the English versions (there were 9 frames in each fotonovela). The second fotonovela can be viewed in full in the JMIR Cancer publication.

Want to learn more about how stories can change behavior? Watch the on-demand webinar, Stories That Move »

Results

Approximately 40% of the patients engaged with the text messages (1,026 patients responded to at least one text out of the 2,597 patients in the intervention group). This is considerably higher than the typical engagement rate with screening reminders. Interestingly, patients who did engage were quick to respond and 86.1% of those who engaged did so within an hour of receiving a text. Of the patients who engaged, 31% clicked on the link to view the fotonovela.

Most importantly, there was a statistically significant 7 percentage point difference in screening: 18.8% of patients in the intervention group were screened, compared with 11.6% of those in the control group.

Social Determinants of Health and Health Equity

A central consideration in the study was to understand whether culturally tailored text messages and fotonovelas could drive behavior change in patients experiencing disparities due to sociodemographic and social determinants of health factors such as race, ethnicity, income, cultural linguistic barriers, and geography.  The results suggest that layering text and visual modalities was particularly effective, with these subgroups showing higher screening rates than the group average. Spanish speakers in the intervention group had an 8.2 percentage point improvement in screening rates (compared to a 5.7 percentage point improvement among English speakers). Similarly, patients in very high need areas and high need areas based on SDOH had an 8.5 percentage point improvement and 7.2 improvement in screening rates respectively (compared to a 2 percentage point improvement in very low need areas). Finally, among those who had never been screened for colon cancer, there was a 6 percentage point improvement in screening rates.

Bringing it All Together: The Impact of Conversational AI and Fotonovelas

Most patients who engaged with the text messages, fotonovelas, and conversational AI had positive or neutral responses and there were very few negative responses. This study underscores how the combination of text, images and tailored responses can help health plans build health literacy and influence health beliefs and behavior in an innovative and culturally relevant way, while achieving positive clinical results. Looking ahead, the mobile health solution in this study provides a robust and replicable model to uncover and address barriers to screening and to improve colorectal screening rates, particularly for disparate and socially vulnerable populations. Increasing the number of screened patients typically leads to more early detection of colorectal cancer, which in turn, can save lives.

The author, Rena Brar Prayaga, is an Impact Tech Advocate and a Behavioral Data Scientist. She is also an Advisor at mPulse Mobile, and a co-author of the study published in JMIR Cancer.

People of mPulse: SriVani Ganti, Director of Health Equity

Posted on by mPulse Team

SriVani Ganti brings a unique perspective to member engagement as Director of Health Equity at mPulse and feels that she and her team play a critical role in making people feel seen.

“For me, when I think about health equity, it’s really personal. As the daughter of immigrants, as a woman of color, I have witnessed systemic racism not just in terms of looks but also in terms of all the assumptions that have been made historically,” she says.

Working hard to address that imbalance and treat people with the dignity and respect they deserve, SriVani feels that mPulse’s solutions are changing the landscape of member engagement. “We have this really cool technology that lets everyone’s experience be bespoke to them, and we can do it in a scalable way. Everyone comes with different perspectives, backgrounds, and narratives, and that means we need different approaches to achieve the same outcomes for each of them.”

Bridging the gap

Having done her Bachelor of Science in Biology through Northeastern University thinking she might become a doctor or a researcher, SriVani realized that neither were for her and went on to achieve her Masters in Health Communication through Boston University.

Having always been her family’s ‘translator’, demystifying what was presented to them when it came to ‘doctor speak’, today, SriVani continues to do just that for millions of people around the country.

With considerable experience in digital engagement, member experience, and health communications through text messaging, interactive voice response, emails and nanosites, SriVani has been focused on these modalities since she joined HealthCrowd in 2016 which later merged with mPulse in 2021. Prior to her time at HealthCrowd, SriVani worked in a few different industries including as a counterintelligence government contractor and Membership Director at a non-profit.

As a result, SriVani understands that delivering the right content to the right people at the right time, and through the right channels is critical when it comes to health equity, and she challenges her team to find new and innovative ways to reach diverse member population groups all the time. 

“My philosophy, when it comes to health equity, is to design for everyone on the margin. Because when we design for them, we include everyone in the middle,” she says. “This inevitably benefits society as a whole,” she adds, citing closed captioning subtitles as an example.

Dedicated to creating the ideal member experience, SriVani describes the Engagement Team as a small but mighty group of individuals, who each bring valuable experience from their different backgrounds, such as public health, behavioral science, health equity, and learning experience to create engaging moments of education that motivate people to take action. This not only helps health plans close important healthcare gaps, but it also educates and empowers members in a more sustainable way.

In fact, during her time at mPulse, the team has worked on a number of fascinating projects including surveys that uncover social needs such as housing, food insecurity, and financial and job instability. Based on these and other insights, they’ve developed a range of solutions focused on improving health equity, such as pregnancy solutions that target and educate Black mothers who experience some of the highest mortality rates in the country, or diabetes management campaigns for Latino populations that provide culturally relevant dietary tips and acknowledge cultural beliefs on how to treat the condition. Additionally, they have created programs in over 13 languages to help improve individual health literacy, which have seen extremely positive results with members seeking out important social services and closing healthcare gaps.

Trusted advisors

As a result, SriVani says she’s proud that, as a team, they’ve become more than a vendor to their customers, they’ve become trusted advisors.

In fact, having attended and chaired the BRI Network SDOH (Social Determinants of Health) Summit earlier this year, SriVani used the opportunity to connect with the industry and really dig into what our customers and their members are struggling with.

“A big part of what drives your personal health outcomes is actually what’s happening around you. It’s not just your access to primary care providers or urgent care, it’s things like financial stability, access to quality education, even the quality of the neighborhood you live in,” explains SriVani, who went on to add that conversations she had sparked all sorts of ideas for what we can do and how can we do it better.  

“The benefit of the mPulse Mobile technology is that we can get messages out there at a wide scale, but more than that, we can make them super personalized to the individual receiving them,” says SriVani, who explains that she and her team are working on a health equity playbook and how to be more inclusive in their marketing.

“The thing with health equity is that you always have to be considering different perspectives. No one should receive the exact same message. Every message should be tweaked based on the person’s background, health, cultural background and more,” says SriVani.

SriVani with her husband, Aditya.

Giving Back

It’s clear that a different perspective is exactly what SriVani brings to the table, as she works to create genuine moments of connection in everything she turns her hand to. Fortunate to enjoy a natural synergy day between her personal passion projects and her day job, SriVani is doing what she loves every day.

Born and raised in Massachusetts, SriVani is now based in Maryland, and credits her parents for shaping the way she sees the world. Growing up watching them give back to those around them, she’s inspired to make a difference in her own way. “I like giving back. I think it goes back to kindness, and if we have more kindness in this world things can only be better,” she says with humility.

A veritable powerhouse, SriVani is proof that dynamite comes in small packages. Aside from volunteering with a local spiritual organization, she co-founded a Hindu environmental organization, is the Director of Communications for a nonprofit dedicated to eradicating maternal and infant mortality rates in India, and is also the co-founder of a South Asian Publishing house, focused on putting out children’s literature featuring children of color.

“Every child deserves to be the hero of a story because if you don’t see yourself, then you don’t believe you can do it,” explains SriVani, eloquently summing up her beliefs when it comes to health equity too.

 

mPulse Mobile Appoints Jay Brookes as Chief Sales Officer and Brendan McClure as Chief Marketing Officer

Posted on by mPulse Team

LOS ANGELES–(BUSINESS WIRE)–mPulse Mobile, a leader in conversational AI and digital engagement solutions for the healthcare industry, announced the appointments of Jay Brookes to Chief Sales Officer and Brendan McClure to Chief Marketing Officer. The expansion of the company’s C-suite increases the healthcare technology expertise among the leadership team and strengthens its commitment to the mission of helping healthcare organizations improve outcomes with innovative technology.

“Healthcare organizations need innovative solutions to meet the needs of modern consumers and drive cost efficiencies,” stated Bob Farrell, CEO. “The combined skills and expertise that Jay and Brendan both bring to our company are invaluable assets for building awareness of mPulse’s unique capabilities that organizations and members are demanding today. I’m thrilled they will continue to lead our sales and marketing teams in strengthening our partnerships with leading healthcare organizations to build out impactful, enterprise-wide digital engagement programs.”

Recognized as an Inc. 5000 Fastest Growing Companies in the U.S., mPulse Mobile’s customer-centric focus and commitment to disruptive, best-in-class technology have made it into a center of innovation excellence within the health engagement space. Its combined conversational AI and health streaming education content are proven to drive engagement and healthy actions among hard-to-reach member populations, including those facing significant social determinants of health (SDoH) barriers.

Read the full press release here.

The State of Health Disengagement

Posted on by mPulse Team

How do we unlock digital to get more people enrolled, lower costs to serve, and improve health outcomes at scale?

That question sums up a major challenge and business imperative to lift programs and people. To frame up that challenge, three key gaps must be considered for meaningful innovation:

The Health Programs Gap

There’s no shortage of solutions or investment focused on the problem. By 2027, the global corporate health and wellness market is expected to exceed $100 billion.

From health coaches to wellness programs, EAPs to DPPs, 401k to HSA, there’s a lot of shorthand around programs that are too often short on utilization.

By the Numbers

At a time when nearly half of U.S. adults report struggles with mental health or substance abuse, only 5% of employees reach out to their EAP. Plus, 6 in 10 are unaware of wellness programs that offer incentives just to engage.

Meanwhile, better convenience and reduced risk of illness are driving more health consumers to telemedicine for mental health and routine care than ever before.

Bottom Line

You likely have many programs in place to support the rising need for total-person care. The opportunity is now to connect your offerings and streamline the digital path to serving the right ones based on need.

By aligning your human services alongside your digital experience journey, you can start shifting from push-based efforts across disconnected programs to a pull-based model that assesses and adapts to the individual’s needs.

The Health Literacy Gap

Patty Starr at Health Action Council sums it up: “Health literacy is the key to lowering healthcare costs and better education is the key to health literacy.”

By the Numbers

As just a sample of an increasingly global problem, 88% of U.S. adults lack health literacy skills needed to manage their health and prevent disease or other illness. 70% of healthcare costs come from lifestyle choices, and people with lower health literacy report worse outcomes.

Bottom Line

Back up. Nearly 9 in 10 adults lack health literacy? That’s a huge number. And part of the problem is that people don’t know their numbers, from reading nutrition labels and measuring medications to understanding lifestyle factors and personal health history.

So if education drives lifestyle choices and choices drive costs, shouldn’t we invest in better education? Yes. But that’s not the problem. From Dr. Google to a WebMD article (designed to sell ads) to a pamphlet to take home, most health “education” is built to inform not to teach.

We know from adult learning theory that simply telling someone to read, watch or listen is not enough. These are inherently passive ways to impart information. If we want real learning and change to occur, we need to design learning experiences that give us ways to reflect, process and apply what we’re learning.

Across need state or wellbeing dimension, a properly designed digital learning experience can personalize to the individual’s needs and guide them to the right programs. In doing so, it can help us solve the health program gap and the health literacy gap at the same time.

The Latent Health Gap

When we look at health programs and services offered today, we see a spectrum from prevention to intervention.

On one side, wellness and benefits offerings are trying to expand beyond hand raisers to help more people quit smoking, move more, or talk to a health expert to start us down a healthier path.

On the intervention side, disease management, care coordination and a host of point solutions are trying to reach people before major issues occur.

That movement to the middle is by no mistake. The vast majority of people show up in the middle. Except, they don’t show up. That’s the problem.

So now that we’ve covered key gaps behind health disengagement, how can we align with evolving consumer behaviors to lift engagement at scale?

Keep Reading: The Future of Health Literacy

7 Ways to Use Streaming Content in Your Health Communication, Part 2

Posted on by mPulse Team

In part 1 of this blog series, we looked at the power of Fotonovelas, Interactive Content, and Animations to drive action in health consumers. All this content does the same thing: it goes beyond just telling a member or patient that taking an action is important. It teaches someone why it’s important and what can be gained or lost by action or inaction.

There are more types of content that can be used to solve some pervasive health challenges, though. In this post, we’ll tackle four of the top performing content types that can be used to do this: Courses, Expert Led Lessons, Stories, and Self-Assessments.

Courses to Manage Anxiety and Depression

The World Health Organization estimates lost production as the result of anxiety and depression costs the global economy over $1 trillion every year.  And, of course, it isn’t just a productivity issue. Mood disorders make it harder for people to stick with treatment plans, manage chronic conditions, and keep doctor appointments, which can have an overall impact on health and cost of healthcare treatment in the long term.

This makes it an important topic for plans and providers to discuss with their health consumers. Our 5-part course, Living with Anxiety and Depression, taught by author and mindfulness guru, Elisha Goldstein, PhD, teaches self-care strategies for navigating the negativity loop that can serve to keep many of us stuck in negative patterns and behaviors making it a truly powerful learning experience. Healthcare organizations can license the content to provide it any number of ways, including in their own branded content portal.

And anxiety doesn’t just affect adults. According to the CDC, approximately one out of every 10 kids (ages 3-17) have a confirmed anxiety diagnosis. The Parenting Kids with Anxiety course led taught by child psychologist and author, Renee Jain, contains five lessons focused on helping parents help their children transform their feelings of anxiety so they can all find calm, courage, and resilience.

Expert Led Lessons to Empower Consumers

Patients can often feel powerless when they engage in the healthcare system. They leave appointments confused. They have care plans they don’t want or know how to follow. They might not know how to advocate for themselves.

To address this and help them take charge of their care, healthcare organizations can provide expert-led video lessons from trusted experts to educate their members and patients on how to take control of their health. For example, Preparing for a Diagnostic Conversation features Dr. Archelle Georgiou who teaches members how to ensure every health decision is their decision, they leave every interaction feeling heard, and that the decisions made reflect their values and priorities.

These lessons can be embedded online, delivered via SMS messaging, or available on a streaming platform. Giving access to content led by reputable and trusted professionals is the first step to ensuring your members and patients take ownership of their healthcare.

Interactive Stories Encourage Diabetes Eye Exams

Started by Snapchat and copied by Facebook and Instagram, stories are now everywhere. Optimized for mobile delivery, they are auto-advancing snips of videos and images which healthcare plans and providers can take and use on social media as another channel to communicate with their populations or repurpose them for SMS delivered solutions. Our diabetes eye exam story below was promoted to at risk populations and is a great example of how the use of stories can educate.

A quick eye exam can detect early signs of diabetes or pre-diabetes. Because of that, getting members to their eye doctor every year is a priority. To help members really understand why doing so matters to them, we could simply send a text or an email telling them it’s that time, and that might work.

We want to help members really connect to the reality of life with eye disease, though, so to take it a step further and ensure the member or patient really understands the reason behind these exams, you can embedd this video you’re your communication program, and it includes a powerful, easy to follow call-to-action.

Self-Assessment to Determine a Need for Preventive Care Screenings

Increasing regular health screenings is an important goal for every health plan. We have an entire library of assets to help members understand when, why, and how to get the most common health screenings (like mammograms, colonoscopies, eye exams, and more).

Below is an example of a simple interactive self-assessment we provide to help members identify which health screenings are most appropriate for them based on what they tell us. Plans may already know what screenings the member is due for, but by providing this activity, it helps the member connect how their personal characteristics connect to their screening recommendations. Once the member receives their recommendations, we then connect them to additional content to help them better understand how the screening works and what their options may be.

The Bottom Line

Health content in the past has largely been underwhelming where pamphlets, brochures, and information documents were the norm. In today’s environment of social media, streaming content, and digital-first experiences, that won’t work. Healthcare organizations have a wide-open world of rich media experiences they can take and adapt for health education, and it’s imperative they do so! Consumers are not impressed with static (and oftentimes boring) content when the rest of their life is starkly different from that.

These are the top 7 content experiences we’ve seen work, but there are more than just these at healthcare’s disposal. Reach out to us to see what else is available for health outreach!

How to Address Changes in Patient Engagement and Motivate Flu Vaccination Fulfillment

Posted on by mPulse Team

Flu season is coming back around, and in a post-COVID world, that means changes in how members engage when it comes to being vaccinated. Lingering perspectives related to vaccine hesitancy may influence members’ reluctance to be vaccinated for the flu despite vaccinations being even more critical to their continued health. Health plans, providers, and pharmacies will have to work harder this year to ensure their health consumers are vaccinated and protected against the flu than they have in years past.

In the 2022–23 flu season, vaccination coverage with ≥1 dose of flu vaccine was 57.4% among children 6 months through 17 years, similar to the 2021–22 flu season (57.8%), and flu vaccination coverage among adults ≥18 years was 46.9%, a decrease of 2.5 percentage points from the prior season (49.4%).

With the unpredictability of flu severity from season to season, outreach and patient engagement to provide information and identify resources for access to vaccinations is integral to a health plan’s ability to proactively communicate with diverse populations through targeted content.

Annually, unvaccinated individuals will cost the healthcare system over $10.4 billion and an additional $17.6 Billion in lost worker productivity.

Flu vaccine patient education can help to prevent:

  • 5 million flu-related illnesses
  • 7 million flu-associated medical visits
  • 105k flu-associated hospitalizations, and
  • 3k flu-associated deaths 

So, what can the healthcare industry do to combat this? With tools like behavioral science, interactive flu vaccine education, and conversational AI at their disposal, it’s possible to see significant increases in flu vaccination rates among members.

Let’s take a closer look at why.

The Foundation: Science of Human Behavior

Let’s start with the basics for any outreach program we run: behavioral science. In this mega-study conducted by The University of Pennsylvania and Walmart, 22 different behavioral science techniques were tested. These 22 varied techniques were embedded into messages delivered through SMS to over 650,000 Walmart pharmacy patients to determine which boosted vaccination rates the highest. Overall, including all these techniques increased flu vaccination rates by an average of 6.7% over a three-month follow-up period.

However, the endowment effect was the most effective technique, which encouraged patients to visit Walmart for a flu vaccine reserved specifically for them. By telling a person a particular flu shot is ‘reserved for you’ and already belongs to them, the vaccine becomes a tangible thing of value that they own. The Endowment Effect is an emotional bias to put a higher value on owned objects. This approach also uses the technique of Loss Aversion, a bias that makes us care nearly twice as much about avoiding loss than receiving an equivalent gain. In this case, if you don’t claim your flu shot, you’ll lose something you own.

We use behavioral science in every program we deploy for our clients, but this study specifically and the endowment effect itself was the basis with which we built our flu vaccination solution for the 2022-2023 flu season. What UPenn and Walmart didn’t have, though, was the following few factors that pushed our flu program beyond even this study.

Streaming flu vaccine patient education

With so much flu vaccine hesitancy in our post-COVID world, flu vaccine patient education about the safety and efficacy of vaccinations is a necessary step, and departing from the mundane pamphlets and brochures of the past by utilizing streaming health content is an extremely effective way to do this.

fotonovela to help improve flu vaccine patient education

The content we’ve produced for flu vaccine education is a series of fotonovelas, which are auto-forwarding image-based stories with a visual interface similar to the stories feature on Instagram. Fotonovelas are ultimately a health literacy tool, but at the same time, they make learning fun and easy (80% of learners on our platform report liking or loving the fotonovela content type).

In this specific flu fotonovela below, the characters featured resonate with diverse audiences, the storylines detailed transcend linguistic and cultural barriers to deliver essential information, and the tone provides empathy and support on the path toward the desired call to action. The best part is that health patients who view a Fotonovela are 72% more likely to get vaccinated.

2-Way conversations uncover barriers

Having 2-way conversations allows you to gather insights about your members that can inform future communication.

  • What is their sentiment toward the program and plan?
  • Why haven’t they been vaccinated?
  • Have they already been vaccinated, and we don’t know?

Knowing why they haven’t been vaccinated allows the plan to respond with education and resources to assist.

  • Do they need help figuring out where to go? Send them the information to their nearest pharmacy.
  • What about if they’re not sure they need a flu vaccination? Send them a Fotonovela to educate them!

Multiple channels, multiple languages

The UPenn and Walmart mega-study tested SMS messages, but why stop there? A large part of an effective engagement strategy is meeting members where they are. As such, our solution includes SMS, IVR, and email channels. Take the concept of meeting members where they are one step further, and you’ll get the ability to deploy this vaccination solution in both English and Spanish. This means reaching more of your population in the way they want to communicate.

Tackle flu early and effectively

The CDC recommends that everyone six months and older, especially people at higher risk, should get a flu vaccine annually to reduce their risk of contracting seasonal flu, alleviate the severity of symptoms, and decrease the likelihood of experiencing major health complications if infected. The importance of each individual vaccinating against the flu needs to be communicated to members through targeted, succinct, and easily understandable materials delivered through channels to reach them where they are most apt to respond and be motivated to act. Studies have found that patients who are informed and effectively motivated are also more likely to adhere to their treatment recommendations.

Our flu vaccination solution

mPulse Mobile’s flu vaccination solution uses proven behavioral science, dynamic content, and an omnichannel approach to overcome common vaccine barriers and get more members vaccinated. With over 15M Flu vaccination touchpoints sent to Medicaid, Medicare, and Commercial members by mPulse in the last two years using its 2-way Natural Language Understanding platform, we have learned from millions of past vaccine conversations in both Spanish and English. We use behavioral science in a relatable and quick experience and employ Fotonovelas to empower members to act. We can help overcome common barriers and resistance by listening for vaccine readiness.

For more information on this flu vaccination solution and a live demo on how we can improve your flu vaccine patient education, register for our webinar, Double Your Vaccination Rates for Your Health Population.

People of mPulse: Eden Brownell, Lead Behavioral Strategist

Posted on by mPulse Team
Meet Eden Brownell, mPulse Mobile’s Lead Behavioral Strategist and resident expert in behavioral science, user design, and public health! As a major contributor to the science behind the engagement programs crafted at mPulse, her efforts help healthcare organizations adjust their initiatives to meet the health needs, boost the confidence levels, and address cultural sensitivities in meaningful ways for their members- essentially reimagining health engagement for the modern age. Eden finds fascination in the intricacies of human behaviors and enjoys “geeking out” (as she loves to put it) on research projects that contribute to the design of our solutions.

“I Love Studying People”

Eden’s journey into this world of behavioral science and healthcare communications started at Saint Michael’s college where she graduated Magna Cum Laude with a Bachelor of Science in Psychology and Sociology/Anthropology. “I love studying people…at first thought I wanted to be a child therapist and work in more of a one-on-one setting,” Eden explained. “I did that for about a year and a half and realized I was too close…but I still wanted to work in healthcare and helping people.” That’s when she discovered public health and subsequently went on to get her master’s degree in Public Health focused in Community Health from Boston University. And Eden is already making a stamp on the healthcare world. She has been awarded an Innovators of Healthcare award by UnitedHealthcare in recognition of her contributions towards a program incorporating social determinants of health data into clinician workflow processes to improve care management and enhance plan members’ health. She is also a collaborator on a Boston Medical Health Equity Accelerator pilot program initiative that aims to improve communication with expectant mothers, uncover care barriers and improve health outcomes for both the mother and child in at-risk populations and underserved communities. The program focuses on supporting prenatal patients through their journeys through the provision of general pregnancy education, preeclampsia support, substance use reduction and cessation, housing instability and mental health management. She has been bringing that expertise and experience to mPulse and our solutions as well over the last few years. As our resident behavioral science expert, Eden is a central figure in the creation of, and educating on the strategy behind our programs. Because she has a vast skill set in Content Design, Applied Behavioral Science, Human-Centered Design, Data Analysis, and Social Innovation, she’s an integral member of the team that crafts the outreach and messaging in all the solutions deployed by mPulse Mobile. She also is an esteemed voice for us in the industry on education within the realm of behavioral science and engagement strategy. She, along with Greg Gould, her counterpart Engagement Strategist at mPulse, have been conducting a 5-part webinar series focusing on behavioral science in healthcare. Essentially, they are advocating for healthcare companies to take an outward look at how other industries and major corporations leverage behavioral science to motivate, inspire and drive action in their consumers, fuel behavior change. Then they teach these organizations how to take that and apply it to their own engagement efforts. She was also recently featured on the popular HIT Like A Girl Podcast, A community committed to elevating Women in Healthcare & Health IT, to discuss her contributions to reimagining health engagement for the modern age.

Making a Difference through Science

In her tenure with mPulse, Eden has made significant contributions to mPulse’s Engagement Strategy team through the initiation of mProv Studio: a weekly, interactive design brainstorming studio that offers the team the opportunity to informally brainstorm ways to innovate solutions and make them exciting and engaging. The studio sessions offer the Engagement Strategy team the opportunity to learn more about behavioral science theories and behavior change principles, address integral aspects of the user experience and learning experience design. Additional collaborations are held to expound upon new content and product design ideas to support content development, streaming activities and the delivery of solutions tailored to the daily challenges within the healthcare industry. Currently, Eden is knee-deep in diabetes research in support of the development of an mPulse Mobile training course in Comprehensive Diabetes Care that will utilize behavioral techniques to help diabetics to optimize their health. The 6-month Diabetes Management program consists of a series of interactive initiatives designed to aid member diabetic patients in: Learning to manage their condition; Examining their personal health beliefs; Increasing their self-efficacy; Setting personal goals and improving their day-to-day diabetes management habits. This is all wrapped up in a solution that includes SMS messaging and versatile multi-media learning experiences to utilize the best that each modality has to offer. This program will empower members to actively participate in their health betterment by learning and practicing the skills of active diabetes management.

Goats, Bulldogs, & Eden

Clearly Eden is incredibly busy as an ambassador, thought leader, and behavioral science expert for mPulse, but she still makes time for personal endeavors. She recently became a certified Yoga Instructor under the International Yoga Alliance and branched out into the exciting world of Goat Yoga! She is a dog-mom to Cooper & Magnolia, her two French Bulldogs, as well as being an avid thriller fiction reader and an aspiring Charcuterie Board designer. The views from her beautiful home office in Boston, Massachusetts are the envy of many members of the mPulse team who are all grateful for her valued contributions and enduring optimism.

7 Ways to Use Streaming Content in Your Health Communication, Part 1

Posted on by mPulse Team

In healthcare, engaging health consumers effectively is becoming increasingly complex. Health plans, providers, hospital systems, and pharmacies deploy various communication strategies – from emails and text messages to phone calls and live events – all to motivate health consumers toward better health decisions. However, the key to capturing attention and prompting action often lies in overcoming knowledge, skill, or motivation gaps. This is where streaming health education, a nuanced form of digital health content, emerges as a vital tool.

But getting someone to stop, pay attention, and act can be challenging. There are many barriers that stand in the way. When one or more of those barriers reflects knowledge, skill, or motivation gaps, streaming health education might supply the nudge that helps move them in the right direction.

Streaming health content, a sophisticated approach to health literacy, merges the strengths of digital content strategy, behavioral science, and instructional design to craft impactful learning experiences. It’s not just about delivering information; it’s about engaging health consumers through diverse formats like animated videos, interactive activities, and expert-led courses. This post delves into seven innovative ways healthcare organizations can harness streaming health content to drive critical health behaviors, starting with the captivating storytelling format of fotonovelas.

As we navigate the ever-evolving landscape of digital health content, it’s clear that the right health content can educate and empower consumers, leading to better health outcomes and adherence to care plans.

Nudging your members to act with streaming health education

What is streaming health education? It’s our take on health literacy promotion. It borrows from the best of digital content strategy, behavior science, and instructional design to create powerful learning experiences for your members.

From short, animated videos and interactive activities to media-rich online lessons and courses taught by leading health experts, there are many different and innovative ways to create and provide content to your health consumers.

In this post, we break down 7 ways healthcare organizations can use digital health content in their engagement programs to drive essential health behaviors, starting with fotonovelas.

Use Fotonovelas to Encourage Flu Vaccinations

Over 3 million Americans get the flu yearly, and the cost to the healthcare system and society in general adds up to a whopping 11.2 billion dollars a year. This is a great reason to educate members on flu vaccinations, which can be done well through fotonovelas, which are character-based stories told through photos or illustrations.

Example of a flu fotonovela included in our flu vaccination solution where health consumers are educatedIn this flu fotonovela, which is one of the four included in our flu vaccination solution, health consumers are educated on why a flu shot matters and common barriers and misconceptions related to flu vaccination. At the end, they’re given an easy resource for scheduling their shot.

It’s ultimately a health literacy tool, but at the same time, it makes learning fun and easy. Behavioral Strategist, Eden Brownell, explained the reason for the success of fotonovelas on the Pharmacy Friends podcast. “The perceived effort is lower. You can provide a large amount of information in a large text message, or you can bundle it up into a fotonovela. [In a fotonovela] it’s broken up. They’re able to see the progression they’re making through the story, which provides them with a sense of accomplishment, and the way it’s being delivered feels easier. When people feel that something is easier, they’re more likely to like it.”

And we find that fotonovelas are certainly well-liked. 80% of learners on our platform report liking or loving the fotonovela content type.

Interactive Content to Promote Medication Adherence

20-30% of medication prescriptions are never filled. Almost 50% of prescriptions are not taken as prescribed. It’s hard for a medicine to work of you don’t take it.

But then again, it’s hard to get your members to abide by their medication regimen if you aren’t addressing barriers to compliance and educating them on the importance of medication adherence. That’s where our second content piece comes in.

Interactive content can do well to educate and motivate health consumers to follow through on their prescriptions. In this series of interactive activities, members gain important knowledge on why and how to follow this critically important part of their care plans – all easily integrated into med adherence and medication management campaigns.

When the member or patient arrives at the interactive content, they can decide which barrier or medication type applies to them and read through the information at their own pace skipping anything they don’t feel addresses their specific situation. And a program like this with content infused has been shown to increase refill rates by 14%!

Interactive health content example to educate and motivate health consumers to follow through on their prescriptions

Using Animations to Educate on the Proper Use of the ER

A recent study from UnitedHealth Group estimated that members going to the emergency room for non-emergencies costs the health system $32 billion annually. Ouch.

But a short video on the proper use of urgent care versus emergency rooms is an excellent example of utilizing animations to educate your health consumers. Able to be sent through text or email or placed on a website or portal, animations are a fun and engaging way to educate. This animation is a prime example of education leading to reduced cost and better healthcare decisions for both the member and the plan, and it’s also highly likely to get your members chuckling. Watch the below animation to see what we mean!

In Part 2…

Health content is aimed at driving healthy actions and educating someone on why those actions should be taken. It addresses health literacy at the same time as it enables plans and providers to reach their own goals.

In part 2, we’ll tackle the next four ways to integrate content into your outreach: lessons, expert-led courses, self-assessments, and stories.

The Future of Health Literacy

Posted on by mPulse Team

In a world where health information is abundant yet often complex, understanding how to improve health literacy is crucial. Health literacy is more than just the ability to read medical pamphlets; it’s about understanding and utilizing health information to make informed decisions and follow treatment plans effectively. The importance of health literacy cannot be overstated, especially considering its impact on healthcare outcomes and costs in the US.

The Health Action Council aptly notes, “Health literacy is key to lowering healthcare costs, and better education is the key to health literacy.” This statement highlights the need to promote health literacy at every opportunity. From Googling symptoms before a doctor’s appointment to discussing healthcare decisions with trusted individuals, every interaction is a potential learning moment that healthcare providers can own and enhance.

Yet, despite recognizing the importance of health literacy in the US, many educational efforts remain dry and clinical, failing to engage modern health consumers effectively. With the rapid growth of the digital health engagement market, there is an urgent need for innovative strategies that captivate, educate, and activate health consumers through trending digital mediums.

Our article will explore three key digital health trends — captivating video content, engaging experts, and personalized community programs — and discuss how healthcare organizations can harness these trends to significantly improve health literacy. Join us in redefining health education and engagement in the digital era with mPulse Mobile’s cutting-edge approach.

What is health literacy?

Health literacy involves acquiring, understanding, and applying health information, enabling you to effectively make well-informed health decisions and adhere to treatment guidelines.

“Health literacy is key to lowering healthcare costs, and better education is the key to health literacy.” – Health Action Council.

You’re heading to the doctor. It’s time for that exam. You Google for quick answers before heading to your appointment. You see the doctor. They hand you a pamphlet and a few sheets of paper that you shove into a bag. When you get home, you text that person you trust. No, they didn’t go to medical school, but they always knew what to do.

Seizing learning moments to improve health literacy

By the year 2030, predictions indicate that the global corporate wellness market will surpass $100 billion, emphasizing the critical role of education in every health solution. Health leaders increasingly acknowledge that effective learning is essential at each step of behavioral change, particularly in addressing low health literacy. Despite significant investments, much of the current health education remains overly clinical and unengaging, aiming to inform rather than truly teach.

Traditional pamphlets, papers, and cluttered health portals filled with YouTube videos fall short of providing a real educational experience in this digital era. This presents a unique opportunity for healthcare to re-evaluate and revamp its approach to improving health literacy, moving away from outdated methods and towards more dynamic, engaging educational strategies.

The unhealthy state of digital health engagement

What do you do when health consumers don’t pay attention? If you’re most wellness programs, you hand out costly incentives in exchange for healthy actions (ex, $300 bucks to complete your annual physical). Meanwhile, telephone nursing and health coaching programs have high operational costs, highlighting the need for better self-directed options.

Because today’s health consumers want to get smart on their terms (and if we want them to learn to make smarter health decisions), we have to meet them where they are.

So how do we do that? How do we teach and guide them to the knowledge and progress they seek? To answer that, let’s look at some of the world’s most engaging digital products.

Embracing digital trends to improve health literacy in the US

Understanding the importance of health literacy is crucial in today’s healthcare landscape, especially in the US, where enhancing health literacy can lead to better health outcomes.

Here are three key digital trends that are transforming how to improve and promote health literacy:

1. Captivating with Video:

With video streaming services accounting for half of the global online time, it’s clear that well-produced videos in a structured, distraction-free environment are pivotal in holding viewers’ attention. This trend underscores the potential of video content to boost health literacy.

2. Educating with Engaging Experts:

The surge in online course enrollments – over five times that of total college enrollments in America – highlights a growing preference for learning from credible, entertaining sources. By leveraging podcasts, online videos, and courses led by appealing experts, healthcare providers can effectively educate and engage their audience.

Takeaway: From podcasts to online videos and courses, people show up to learn from experts with consumer appeal.

3. Activating with Community and Personalized Programs:

Programs like Peloton demonstrate the power of expert-led, community-supported experiences in inspiring real-life achievements. This trend reveals the value of communal learning and personalized programs in fostering health literacy.

By tapping into these digital trends, healthcare providers in the US can revolutionize their approach to health literacy, making it more engaging, accessible, and effective for their consumers.

How can you use these digital health trends to promote health literacy?

To effectively harness digital health trends and improve health literacy, the key lies in combining expertise in learning, content creation, and technology.

At mPulse Mobile, we’ve assembled an elite team of professionals in these domains to develop a comprehensive digital curriculum encompassing physical, financial, emotional, social, and career health. By developing strong partnerships with best-selling authors, TED speakers, and renowned physicians, we create custom and licensable health education content that rivals the engagement level of streaming television. 

Our advanced learning software supports a growing library of holistic health content, offering a quicker, more cost-effective route to enhance health literacy and engagement. This approach is designed to integrate seamlessly with your existing digital ecosystem, aligning with your brand and broader health programs and providing an innovative solution to improving health literacy.

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To learn more about mPulse’s digital health solutions and outcomes, Contact us at info@mpulse.com

What Type of Healthcare Chatbot Do You Need?

Posted on by mPulse Team

Chatbots play an increasingly important role in healthcare. In addition to improving member and patient satisfaction, many chatbots gather data through conversations, providing rich, new sources of health data that can inform care at the individual and population level.

This post walks through nine different types of healthcare chatbots, the role chatbots play in healthcare, and recommendations to consider when using a chatbot to help serve your patients or members.

Types of Healthcare Chatbots and Their Value

Appointments

Scheduling (and rescheduling) healthcare appointments is a relatively simple process that has historically required at least one staff member for each appointment and been very time consuming. This is where appointment scheduling chatbots come into play. These chatbots make It easy for a patient to schedule an appointment on a website, inside a portal, through an app, or even via text message while including valuable information like reason for appointment, symptoms, etc.

In many cases, appointment scheduling chatbots need to be integrated with an EHR system to be most effective, which allows for automatic scheduling and re-scheduling with little to no human intervention. And when PHI is properly managed, these chatbots may also be able to deliver valuable information like lab results directly to the right patients.

Symptom Checker

At their best, chatbots provide more valuable and relevant information than a web search. They are able to do this because they are siloed; if a user is within a healthcare chatbot’s ecosystem, it can be assumed their questions are all healthcare related. When a user searches on the web, results often need to be broader to address a variety of intent.

In addition to an improved experience, as chat often feels more personal than search, symptom checker chatbots rely on a blend of healthcare experts to provide reliable data and Natural Language Understanding to analyze patient and member symptoms, return helpful information, and recommend care.

At their best, symptom checker chatbots align with appointment chatbots to help patients and members get necessary care with limited barriers.

Health Tracking

Many patients and members have ongoing health needs such as care prior to, day of, and following a procedure. These chatbots typically feature timely check-ins, medication / care reminders, and the ability to understand if a patient or member is reporting an adverse condition. These chatbots need to be able to log a record over time to be most effective and relevant.

Chatbots that help users with fitness or diet goals often fall into this category as well.

Chronic Condition Self-Management

Properly managing chronic conditions is an ongoing challenge for healthcare organizations and their consumers as chronic conditions require a blend of ongoing tracking and specific care as challenges related to the condition shift. Whether coordinating care, reminding people to take medication, providing valuable information or many other uses, these chatbots need to be able to both provide tailored information and react to changing individual needs.

Similar to Health Tracking chatbots, Chronic Condition Self-Management chatbots help users track and manage their condition on an ongoing, long-term basis. They typically require a more specific medical knowledge base than Health Tracking chatbots.

Engagement

Everything people do impacts their health. One challenge healthcare organizations face is getting people to engage with their health and healthcare. Afterall, there are so many other things that fill time and mindshare. Patient and member engagement chatbots create meaningful experiences and find valuable ways to connect with people and engage them in their health, whether by providing an important health reminder, uncovering some new healthcare information / status, getting a mental health update in real-time, or many other uses.

Engagement chatbots typically focus on consistent touchpoints and a long-term relationship with patients and members.

Digital Front Door

Chatbots are a key component of many successful digital front door applications. Digital front doors provide a virtual experience similar to a really great waiting room where a nurse collects key information to help optimize your visit and route care accordingly. Chatbots play a vital role here as they act as a combination receptionist, nurse, and source of information.

Digital Front Door chatbots must be personable and useful to consumers while gathering key information that helps healthcare organizations optimize care resources.

 FAQs

While a symptom checker chatbot helps address patient and member questions about their health, FAQ chatbots help address questions about healthcare. The goal of FAQ chatbots is to provide a better experience and easier access to answers than scouring a healthcare organization’s website or portal in search of answers. Similarly, they reduce the burden on call centers by reducing inbound calls to find answers to common questions.

A smart FAQ chatbot is able to ask the user questions to refine and deliver the best answers.

 Inbound vs Outbound Chatbots

Like any conversation, an interaction with a chatbot can be started by a consumer (inbound) or by the chatbot (outbound). In most cases, chatbot conversations are inbound as they trigger when a consumer visits and app or website and begins a chat. The challenge with inbound chatbots is they require a consumer to take an action (sometimes a few actions) before the conversation can begin. Outbound chatbots are less common as they require an existing, open channel to work. The best example of outbound chatbots is those that communicate through SMS or RCS, reaching consumers directly in their text message inbox.

mPulse Mobile offers a variety of solutions that feature outbound chatbots.

How Chatbots Need to Work Together

The overall goals of healthcare chatbots are to improve patient and member experience, optimize healthcare staff, help people stay healthier, gather valuable data, and make organizations more efficient. While specific chatbots can help address specific needs, a holistic approach is needed to accomplish all of these goals.

Learn how mPulse Mobile is combining omnichannel patient and member engagement with streaming health education to help solve many of healthcare’s biggest engagement challenges.